WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)ABCDEFGHIJKNavigating the grey zone in the response to child abuse andneglect in primary healthcare settingsMiss Jacqueline Kuruppu1, Cathy Humphreys1, Gemma McKibbin1, Prof Kelsey Hegarty1,21The University of Melbourne, 2The Royal Women’s HospitalBackgroundChild abuse and neglect (child abuse) is a common issue that leads to significant health issues. Giventhe association between child abuse and health, mandatory reporting laws for doctors and nurseswere introduced in jurisdictions such as the US and Australia. However, this legislation is not globallyor nationally consistent. Thus, there is confusion surrounding the definition of abuse that should bereported and how to respond when suspicion does not meet the threshold of Child Protection. It isunclear as to how health professionals navigate the response to child abuse in light of this confusion.Aim of the studyTo explore how Australian GPs and nurses navigate their response to child abuse and neglect inprimary care.ContentTwenty-two GPs and eight nurses were sampled from private general practice and community healthclinics and Doctors in Secondary Schools, an initiative in the Australian state of Victoria that placesGPs and nurses in high schools. Twenty-six in-depth individual and group interviews were conducted.The interviews were analysed thematically.Principal resultsWe generated three themes: negotiating the threshold; mismatching expectations; and practising inthe grey area. Participants engaged in a process of negotiating between their immediate colleagues,with families and with statutory Child Protection authorities. When participants decided to make areport, they were met with a response from Child Protection that did not match their expectations.This led to feelings of distrust directed towards Child Protection authorities, which left participantsto manage patients within a ‘grey zone’. While practising in the grey zone, participants attempted tocreate an emotionally safe space for patients and engage in practical strategies that responded topatient vulnerabilities.Goals• To describe the ‘grey zone’ in relation to clinical practice• To encourage GPs and nurses to critically reflect on their response to child abuse.347
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